Experiences of Healthcare Providers

University of Perpetual Help System Laguna
Minante Uno, Cauayan City, Isabela

BASIC EDUCATION DEPARTMENT
Biñan Calamba GMA Isabela Las Piñas Manila Molino Pangasinan
CHAPTER I
THE PROBLEM AND ITS SETTINGS
Introduction
Barangay Health Workers(BHW), also known as Barangay Health Volunteers, are
one of the members of health care providers in the Philippines. They undergo a basic
training program usually provided by the Local Government Unit Health Service to pro-
vide basic, safe, and effective health care services to the community people, and give pri-
mary care services in the community. They provide basic maternal, newborn, and child
health services for the all members of the barangay. A BHWis one of the front-liners who
provide health care services for the barangay. BHW are vital in Barangay Health Centers
because they provide assistance and support to physicians, dentists, nutritionists, public
health nurses, and midwives. Collectively, they are considered guardians of the nation’s
health.
BHW is qualified to provide primary health care services in the community it is
serving based on the guidelines given by the Department of Health. Here are just a few
responsibilities of a barangay health worker: first aid, equipment sterilization, assisting in
health center activities, collecting vital statistics, maintaining records and making reports,
participating in community meetings, assisting in nutrition education, monitoring and
feeding, assisting in immunization education, monitoring, and dispensing, assisting in
family planning services, assisting in sanitation and hygiene promotion and education.
BHW’s are very important part of the community’s fight to the attainment health
for all, prevention of diseases, and giving basic nursing care. They are the future’s new
hero for their never-ending weariness just to keep the community healthy (Pineda, 2016).
Health services should be accessible to all citizens. The population growth
experienced after the first democratic elections in South Africa in 1994 resulted in some
populations having limited access to health services in some parts of the country as there
was influx of migrants to urban areas who settled in informal settlements thus increasing
the population in these cities exponentially. These areas are populated mostly by people
who are often unemployed, live in poor living conditions and who have insufficient
access to health services (Taleshi, 2009).
The rural health midwife or the assigned midwife in barangay attends to medical
needs of of expectant of mothers-to-be as they go through their pregnancies, responds to
minor health concerns and immunizes children in her office in the barangay hall
R.A.7883 is The Barangay Health Workers’ Benefits and Incentives Act of 1995
which is an Act granting benefits and incentives to accredited BHWs for voluntary health
services rendered to the community.
The intention of this study is to identify the experiences and the problems
encountered by Health Care Providers.

Theoretical Framework
The researchers have learned that in order to make their study more valid and
reliable. They must use primary source which are supported with theory. The researchers
made used the Tannahill Model of Health Promotion (1980).
In the year 1980, Andrew Tannahill created a health promotion model consisting
of three overlapping subjects of activity: health education, prevention and health
promotion.
Health education is designed to change the knowledge, beliefs, attitudes, and
behavior in a way that facilitates health. Disease prevention aims to decrease risk factors
and minimize the consequences of disease; it includes primary, secondary, and tertiary
prevention. Health protection focuses on fiscal or legal controls and policies and
voluntary codes of practiced aimed at preventing ill health and enhancing well-being.
Tannahill(2009) asserts that health promotion includes public policies that address fair
access to housing, employment, education, and health care.
The Tannahill model has been criticized as being clearly within the reductionistic,
medical model in that it pays insufficient attention to community-based factors. In
response to these critiques, Tannahill(2009) proposed a new definition of health
promotion as the sustainable fostering of positive health and prevention of ill-health
through policies, strategies, and activities in the overlapping action areas of: social,
economic, physical, environmental, and cultural factors; equity and diversity; education
and learning; services, amenities, and products; and community-led and community-
based activity.
Education in his definition includes health education and interventions designed
to promote empowerment, such as resilience, self-esteem, and life skills. Service and
amenities include preventative care, while products include those that enhance health
along with those that damage it
Statement of the Problem
The study focused on the experiences of health care providers. Specifically it aims
to answer the following questions:
1. What are the experiences of health care providers?
2. What are the challenges experienced of health care providers?
3. What are the coping strategies of health care providers in overcoming these
challenges?
Assumption of the Study
In conducting this study the following assumptions were made. It was assumed
that:
1. The participant in the study freely provide the researcher with a response
regarding on their experiences of being a heath care provider.

2. The researchers also assume the challenges of the participants at work and their
coping strategies in overcoming it.
Scope and Delimitation
This study is covered by healthcare providers only who were the barangay health
workers and midwife. The participants were limited to eight health care providers; seven
barangay health workers and one midwife. The general intent of this study is to identify
the experiences of healthcare providers.
Significance of the Study
The results of the study will be great benefit to the following:
Future Researchers- the ideas presented may bewill be use as reference data in
conducting new researchers or in testing the validity of other related findings.
Researchers- this refers to the students conducting the study. Researchers will find their
self-fulfillment in this study. This study will help and aspire more researchers to be more
innovative that will be beneficial.
Barangay officials- the result of the study will provide valuable information that they
must learn to value health volunteers in barangay and conduct more programs which are
health related.
Barangay Health Workers- the information that will derived from this study will be
very helpful in the improvement of their work, this will help to play the role and work
that is given to them. To make them realize that the experience of being a health worker
in barangay is challenging work.
Midwives- this study will help them to realize that working with barangay health
workers is not a cheap option.
City/Municipal Mayor To increase the moral and financial support for barangay health
workers and midwives.
Community Residents To inform them that being a health worker and midwife in a
barangay is not a profitable work but a volunteer work with a only insufficient allowance
and benefits.
Definition of Terms
For a better understanding to the study, the researchers defined the following
terms conceptually and operationally:
Barangay Health Centers- used manual system in terms of implementing medical
services, health programs, health monitoring and profiling (www.inetutor.com).
Community Health Centers- is a not-for-profit, consumer-directed health care
organization that provides access to high quality of, affordable, and preventive medical,
dental and mental healthcare (www.mtpca.com).

Directly Observe Treatment Short-cause(DOTS)- is a strategy used to reduce the
number of TB cases. In DOTS, healthcare workers observe patients as they take their
medicine (www.medicinenet.com).
Experiences- this refer to the lived and work experiences by health care providers.
Front-liner- this refer to the Barangay Health Worker who provide healthcare services in
barangays.
Healthcare Providers- these refer to the Community or Barangay Health Workers and
the midwife assigned in a particular community or barangay.
House-to-house visitation- this refer to the part of work of health care providers during
vaccination.
Integrated Management of Childhood Illness(IMCI)- integral approach to child health
that focuses on the well-being of the whole child. IMCI aims to reduce death, illness and
disability, and to promote improve growth and development among children under five
years of age( World Health Organization).
Intervention- is a combination of program elements or strategies designed to produce
behavior changes or improve health status among individuals or an entire population.
Interventions may include educational programs, new or stronger policies, improvements
in the environment or a health promotion campaign. It may be implemented in different

settings including communities, worksites schools, health care organizations, faith-based
organizations or in the home (health.mo.gov).
Morbidity- refers to having a disease or a symptom of disease, or to the amount of
disease within a population. Morbidity also refers to medical problems caused by a
treatment (National Cancer Institute).
Mortality- the number of deaths in a given time or place (Meriam Webster)
PhilHealth Insurance- is a governmental health care program that has been established
since the early 1960s, when the Philippine Medical Assistance Association pioneered the
MARIA project which prioritized aid to communities in need of medical assistance
(Neri,2017).
In the study this refer to the benefit for BHW must have.
Pinoma, Cauayan City, Isabela – refer a place where the study conducted.
Primary Health Care- is an approach to health and well-being centered on the need and
circumstances of individuals, families, and communities. Rooted in a commitment to
social justice and equity and in the recognition of the fundamental roght to the highest
attainable standard of health (World Health Organization).
World Health Organization- is an agency of the United Nations(UN). It mainly deals
with pubic heath matters of the people around the world. Also acts as a coordinating
authority on international public health (definition.uslegal.com).

CHAPTER II
REVIEW OF RELATED LITERATURE AND STUDIES
Foreign Literature
Thomson(2016) stated that CHW plays a huge role in promoting both health care
and social support in the communities in which they work, and indirectly in the
communities in which they live. The CHW role has been part of a broader labor context
within South Africa where the blur of boundaries of employment and volunteerism was
and still prioritized. The passion of the CHWs to help is something valuable to be
supported and nurtured.
CHWs serve as a person who helps organization and provide information between
health or social services and individuals in their communities. These are the people on the
frontlines, providing advocacy, information and education to community members in
order to help them improve their lifestyle and link them to their healthcare option. Jobs
for CHWs are expected to increase 25% through 2022. In order to become a CHW,
education requirement is required vary depending on the type of CHW you decide to
become, important skills and characteristics are also a requirement to become (
Elrick,2015).
According to Elrick(2017), CHW impact individual lives by improving public
health and it’s a very important task. CHW do their part in this important feat by
connecting marginalized communities to health sources, furthering education about
healthy living, acting as an advocate for the community, providing informal counseling
and social support, making home visits and providing health services, and improving
communication.
Many low- and middle-income countries face a shortage qualified health
personnel (WHO,2006). This worsen the problem of poor access to health services
particularly in rural areas. The use of CHWs to address human health resources crisis is
gaining popularity in these countries (Haines et al.,2007). In sub-Saharan Africa
Countries, CHWs are increasingly required to act as front-line clinicians, notably in
efforts to fight HIV/AIDS and malaria ( Druetz et al., 2014, Scheinder et al.,2008).
CHWs plays an essential role in the task-shifting policy promoted by the World
Health Organization (WHO,2008).
CHWs are usually defined as individuals who received basic health training and
work in the community where they live. The range of activities now entrusted to CHWs
is broad; they are used to disseminate health messages, support immunization campaigns,
facilitate referrals to health centers or administer treatments for the most widespread
diseases namely malaria, pneumonia, and diarrhea (Liu et al.,2011, Standing and
Chowdhury,2008).
Using CHWs to administer treatments in remote areas and reduce the burden of
diseases has been an ongoing strategy since the selective primary healthcare policy was
established in the 1980s. It is suggested that this strategy is effective in reducing
morbidity and mortality (Lewin et al.,2010, Winch et al.,2005).

Foreign Studies
Patients who are at high at risk for unfavorable medical outcomes because of
poverty, poor education and poor health habits was taking care of community health
centers. Health centers are placed to implement systems-level changes affecting many
patients because of their population focus. They report there on a successful quality
improvement initiative focusing on patients with diabetes in Holyoke,Mass. In 1999, to
track the patients of Holyoke Health Center they adopted and electronic registry and
their clinical data as part of a bigger effort to apply an integrated approach to chronic
disease management. In 2003, CHWs were added to the diabetes care team to enhance
the capability to engage and support patients who were not succeeding in managing their
diabetes( Liebman & Hefferman,2008)..
As (Haines et al.,2007) stated, there is new interest in potential contribution of
CHWs to child survival. CHWs can undertake various tasks. Several trials express
important reductions in child mortality, particularly through case management of ill
children by these types of community interventions. However, CHWs are not a cure for a
weak health systems and will need focused tasks, tolerable salary, training, supervision,
and the active involvement of the communities in which they work. The important
programs for CHWs requires evaluation to document the impact on child survival and
cost effectiveness and to clarify factors associated with success and sustainability.
According to (Abdel-all et al.,2017) CHWs are increasingly being appointed to
prevent and manage cardiovascular disease and its factors in underserved populations in
low-income and middle-income countries. However, petite is known about the required
training necessary\for them to accomplish their role. The results of the eight included
studies suggests that CHWs can be trained effectively for cardiovascular disease
prevention and management.
CHWs were deemed to be impacting negatively on their work experiences: the
lack of career pathing process; sufficient career guidance; and inadequate employment
process such as staff retention, succession planning, and promotion (Vissagie and
Pilay,2017).
CHWs can take an active role in the delivery of community based primary
healthcare intervention linked to the health facility. CHWs have demonstrated that they
can effectively manage health and family planning information and distribute
commodities that were once regarded as functions of formally-trained health workers
(Haver et al.,2015)
CHWs are recognize in the patient protection and affordable care act as important
members of the health care workforce. Evidence prove that they can help improve health
care access and outcomes, strengthen health teams and enhance quality of life for people
in poor and diverse communities (Rosenthal et al.,2010).

Training of CHW is an integral part of Iranian primary health system and
considerable attention has been made to make sure that the training content, duration and
approaches matches with educational qualification of CHW students as well as
community health needs. However, the length of the training course and its content raise
questions about how far the Iranian Behvarz can be compared with the CHW in other
developing countries where the community health workers typically receive very little
initial training and are more akin to lay workers than professionals (Javanparast et
al.,2012)
CHWs are key bridge between communities and the health system. For them to
be able to empower communities they must themselves be empowered. They must
involve themselves with health services which empowers them in many ways. However,
many CHW program aspects undetermined this empowerment they need to be better
supported with the health services (Kane et al.,2016).
Emergency department health care worker are at risk of experiencing workplace
violence and should have specific training and support in the management of violent
situations focused on early identification communication strategies, and de-escalation
techniques (Cannavo et al.,2017).
According to Hatzler(2018), CHWs have the capability to enhance primary care
access and quality, but remain underutilized. Table 1 shows the community health
workers-in primary care function such as health coaching, care coordination, providing
social support, health assessment, resource linking, case management, medication
management, remote primary care, follow-up, and health literacy report while the Table 2
depicts the community health worker-in primary health care roles. It was concluded that
CHWs in primary care focus core functions that cluster CHWs’ role.
According to (Hill et al.,2017), Table 2 summarized that most CHWs delivered
the intervention activities and facilitate the group sessions. These included developing
and organizing activities to promote healthy diets and physical activity such as weekly
senior citizen walking club, diabetes awareness and prevention events. They are also
healthcare providers. Table 3 shows that diabetes prevention programs that targeted
vulnerable communities highlighted the importance of CHWs in contributing their
accessibility and appropriateness.
Tsolokille et al.(2014), shows that CHWs fulfill a different roles in the
management of non communicable diseases. As such they have important role in
community level of non communicable disease public healthcare in South Africa. Playing
the role as health educator meant that CHWs are expected to act as source of information.
The study also highlighted the the short falls in CHWs knowledge, in that information
provided was not accurate. The inability to clarify certain nutrition concepts emphasize
the need for training and continuous education that is tailored to the context that
addresses the everyday realities of CHWs, as well as the need for teaching aids to further
enforce and standardize the health information give to clients. Indeed it has been
suggested that the community’s perception of CHW’ knowledge, skills and ability to
assists communities with their health need is important in inspiring respect and
acceptance of CHW services.
According to BMC International Health and Human Rights (Perez et al.,2009),
every year an estimated 11 million children in developing countries die before they reach
their fifth birthday. 73% of these deaths are because of diarrhea, malaria, acute
respiratory infection, measles, and malnutrition. But these deaths could be prevented by
the presence of CHWs that are trusted to implement in resource-poor setting. But because
of the poor access to health services, insufficient resources at household level, poor
knowledge and practice among care givers and inadequate quality od facilities which
leads to low intervention in Sub-Sahara, Africa.
According to US National Library of Medicine National Institutes of Health(
Kash, May & Tai-seale,2006), CHW programs in United States seem to have been
initiated mainly due to lack of access to health care services in culturally, economically,
and geographically isolated communities. But if CHW are trained and certified they
would have a great potential for new and skilled healthcare workforce that could help
improve healthcare access and utilization among undeserved population in the US.
Reliance on CHW for HIV care continuous to increase particularly in resource-
limited settings. CHWs can improve HIV service use and adherence to treatment, nut
effectiveness of these programs relies on providing and enabling work environment for
CHWs, including reasonable workload, supportive supervision and adequate training and
supplies( Busza et al.,2018).
Local Literature
The Barangay Health Workers (BHWs) have a tour duty in assisting midwives
and Municipal Health Office staff in operating the birthing stations. The BHWs training
in maternal and child health care aimed to enhance local capacity particularly on
women’s health and safe motherhood which an important component in reducing
maternal and child morbidity and mortality (Flores, 2011).
BHWs undergo training programs under accredited government and non-
government. They are accredited by the local health board in accordance with the
guidelines set by the Department of Health(DOH). BHWs voluntarily act as health
educators, community organizers, and primary healthcare providers in their local
communities. BHWs are also in the frontline of providing maternal, newborn, and child
health care ( Rodriguez,2014).
Due to a lack of barangay health station and facility in Bag-ong Dalaguete, one
midwife who is a Local Government Unit employee is assigned to monitor the health and
the nutrition status of the residents particularly the children. The assigned midwife caters
four other barangays and is scheduled to visit every Tuesday of the month. Aside from
midwife the barangay has also one BHW who monitors and tracks pregnant woman in the
barangay (Belcina and Selisina, 2018).

According to The Daily Guardian(2017), the annual training for BHWs is one of
the activities under Global Business Power Corporation(GBP) adopted a health center
program. GBP is aware of the very important role of BHWs and the Kagawads in charge
of the health committee in the delivery of health services in the community. This role has
to be taken seriously because it is ultimately the life of the human individual that is at
stake. GBP help to complement their skills through the BHW training to capacitate them
and be more than ready to deliver to the community health services that are expected
from them.
BHWs will bring the healthcare system through the casual conversation, they give
an information regarding on birth spacing and family planning. Because of their training
receive from DOH and other health care organizations, the BHWs can give advice on
childcare like vaccination and deworming (Santos,2015).
BHWs part of their daily tasks have included implementing nutrition programs,
monitoring children’s weights and heights, assisting the midwife and accompanying
researchers and anything that is related to health-care. They only get a monthly allowance
of Php1,150 from the local government, being officially classified as volunteer.
Challenges of being a BHWs are often dragged into local politics, they need to participate
in a political activities to support the party of their barangay captain in order for not to be
fired(Lasco,2018).
In 1995, Republic Act 7883( Barangay Health Workers and Benefits and
Incentives Act of 1995) sought to provide incentives to them in recognition of their
services. Is is specified that BHWs are entitled to hazard and subsidence allowance
trainings, civil service eligibility, free legal services, and access to loan services. But
according to Panay News(2017), it did not provide fixed rate allowances and local
government units vary in the rates and benefits they provide. Consequently, many BHWs
become underpaid and receive far less than what their other counterparts get.
Araneta(2017), BHW is voluntarily give primary health care services. BHW must
be given a training on the use of a medical tools, diagnostic instruments and blood testing
kit, which help them in the diagnostic prevention monitoring, treatment and alleviation of
disease in a community.
Primary Health Care Service Providers is fitting for the government of Bacolod
City to provide PhilHealth Insurance benefit to all the BHWs. But in order to avail the
insurance benefit, the BHW shall get and submit his/her assigned tasks which shall be
issued to by the barangay health station where the concerned BHW is assigned.
BHW in Atok, Benguet often climb up mountainous barangays just to visit
families in need of health and nutrition assistance. BHWs not only stay in the barangay
health stations, but also go out to the field. During home visits, BHWs meet parent who
lack knowledge and on proper nutrition and child care( Rodriguez,2014).

Other public health programs and health workers were also greatly
affected in the post-Dengvaxia scandal. After the dengvaxia scare, parents were afraid of
any kind of intervention, not only for vaccination( Tomacruz,2018).
Local Studies
According to Ateneo De Zamboanga University (Aipichi,2007), Barangay Health
Workers (BHWs) are essentially the frontline health service providers of the community
health centers. They serve as the assistant ego of the barangay health nurse if present.
These BHWs therefore has to equipped with knowledge and health teaching skills. In this
study, the researchers found out that film viewing and with the combination of health
teaching training session are effective in improving the knowledge and health-teaching or
competency of the BHW.
As eloquently stated by Itturalde(2010), BHW serve as community volunteers
serving community health centers without fixed salary compensation. They often serve as
added workforce serving as extension work by doing manual such as helping in
maintaining the cleanliness of the center, guiding and controlling patients’ record and
patients flow in the clinic, and inviting community individual to attend health educational
activities. BHWs are also effective in motivating lactating mothers through group
counseling toward exclusive breastfeeding practices.
Ampong(2006), in her study revealed that enhancing the knowledge and skills of
the BHWs improve the hypertension case finding and compliance of community
residents to visit the healthcare centers to blood pressure monitoring service. But through
education and training should be done by BHWs to ensure knowledge retention and
accurate blood pressure taking practice. As studied by Juhan(2014), BHWs are effective
in increasing the knowledge and improving the blood pressure monitoring compliance
among hypertensive individual in Barangay of Diplahan Municipality, Zamboanga
Sibugay Province
With the proper training of Integrated Management of Childhood Illness(IMCI)
algorithm to the BHWs in identifying common skin conditions. BHWs underwent
exposure to the full course of IMCI which includes both interventions-lecture on common
skin conditions and training intervention on the use of the IMCI algorithm(Aquino,2016).
The actual demonstration with corrective feedback and repetitive video on breast
self examination (BSE) skills are both approaches equally in enhancing the skills among
BHWs. The researchers found out that corrective feedback would be more advantageous
because it requires less cost and effort although more time consuming that the video
group which showed an early improvement of BSE skills among BHW (Bolodo,2014).
Credo(2009), in her study concluded that the establishment of modified DOTS
sites with performance-based incentive program among the BHWs can motivate BHWs
on strict enforcement of DOTS strategy thus contributing to the improved treatment
adherence and compliance by the TB patients

Human health resource is a problem that evidently exists in the Municipality of
Diplahan. BHWs in the grassroots level would be valuable in addressing these problems
on high incidences of pneumonia. In the municipality, considering that pneumonia
remains in the top ten morbidity cases of the said municipality. The lecture with the
demonstration as a form of intervention in improving the skills of the BHWs in
assessment referral of Acute Respiratory Infection is effective (Madamba,2014).
Diarrhea especially among children is common and usual and one of the top 3
morbidity and mortality in rural areas. BHWs are the one in charged in healthcare system.
Further trainings for the BHWs could improve their competency in terms of detection and
first-line management common diseases i the community(Alfaro,2008).
Llagas(2008)stated that trauma has the leading cause of mortality in Sergio
Osmena due to mode of transportations and unconstructed highways which leads to
accidents. It is the reason in conducting health education through lecture, demonstration
and bandaging where BHWs are in charge to provide emergency healthcare in their
barangay. The health education on basic life support and bandaging is useful in
increasing the knowledge and skills of community residents.
The deliver and success of health strategies like the Control of Acute Respiratory
Infection program greatly depend on the end implementators like the BHW. The training
and competency which include the knowledge and skills for the BHWs are important to
be assessed and monitored (Caniete,2005).

Taburnal(2017) in her study revealed that healthy living in the community is
affected by many factors with the presence of BHW who inspires and motivate
community people to live in a healthy lifestyle, which are competent, committed a having
the relevant as BHW can provide quality healthcare services to their constituents. The
personal, political, and environmental factors affect the level of competence of BHWs.
The continuous attendance to seminars and trainings are highly recommended to enhance
their performance.
Communication strategies used by barangay health workers in promoting
reproductive healthy among Iraya-Mangyan communities. It was revealed that the Iraya-
Mangyan comnmunities strong prefered inmdividual channels(i.e.,home visits and
counseling) in communicating rewproductive health information. When it comes to the
approach used in communicating RH information , the respo9ndents’ preferred the
entertaining approach.
CHAPTER III
RESEARCH METHODOLOGY
This chapter describes and discusses how the researchers will gather the necessary
data and information that will be used in the entire study. It describes who will be the
participants and focus of the research. This also shows the procedure of data collection
and instruments used; these chapters also discuss the type of research, research method,
and the research local where the study will be conducted.
Research Design
The study made used of qualitative research design. This study aimed to
determine and identify the experiences of Healthcare Providers in Barangay Pinoma,
Cauayan City, Isabela.
The researchers employed a phenomenological research design and methodology

to achieve the objects of the study.
Population of the Study
The participants needed in the study were the Health care Providers who were the
Barangay Health Workers and assigned midwife in Pinoma, Cauayan City, Isabela. The
following participants consists eight Health Care Providers: seven Barangay health
workers and one midwife.
Sources of Data
The researchers made use an interview as the source of data. According to

McNamara(1999), interviews are particularly useful for getting the story behind a
participants experiences.
Instrumentation and Validation
The instrument used in the study was semi structure questions. The developed
questions underwent validation by the experts in the field and research. After the
corrections and suggestions were incorporated in the questions made, it was used in
gathering the needed data for the study.
Data Gathering Procedure
The researchers made a letter address to the Barangay Captain of Pinoma,

Cauayan City, Isabela, to ask permission to conduct an interview to the Health Care
Providers. The researchers conducted the interview in Pinoma, Cauayan City, Isabela;
after the permission granted by the Principal.
The benefit of interviewing is that the researchers can gather raw and more
reliable data that is directed to their study.
After gathering data and information, the researchers interpreted the responses
from the participants. The results would hopefully helpful to the researchers.
Ethical Considerations
Ethics are the norms or standards in conducting research that distinguish between
right and wrong. Ethical standards prevent against the fabrication or falsifying of data and
therefore, promote the pursuit of knowledge and truth which is the primary goal of
research. Using the ethical consideration, the participants may give their opinions about
the research.
Researchers will present the consent to the participants. Research participants

should not be subjected to harm in anyways. Respect of the participants should be
prioritized. Protection of the privacy for the participants has to be ensured. Any type of
communication in relation to the research should be done with honesty and transparency.
These ethical considerations should be followed.
Treatment and Analysis of Data
The gathered data from audio recordings and interview forms were transcribed.
The researchers began to analyze after the gathered data with transcribed process.
Through the use of thematic analysis, all the responses of the participants were critically
analyzed by the researchers.
The data were presented through the phenomenological presentation. The

researchers were objective in analyzing the data, setting aside personal perceptions, for
reliability and validity of the study.
CHAPTER IV
RESULTS AND DISCUSSION
The purpose of this study was to determine the life and work experiences of
health care providers. The process in interviewing the participants was utilized by the
researchers to gather a necessary information about the participant views, experiences,
and perspectives. The interviews were conducted among seven (7) barangay health
workers and one(1) midwife.
The researchers asked four main questions and some follow up questions which
are related to the main questions. The participant answers by the researchers found
four(4) purposes in the study.
Life Experiences of Health Care Providers
The first purpose was about their life experiences. Five out of eight health care
providers stated that they really want to help community residents and to serve as a
public servant.
“Yes of course. Sa tagal ko na kasi dito sa serbisyo hindi lang 30 years na, kaya lang nag
ano ako nung umalis ako. Father-in-law kasi yung matagal na naging kapitan wala pang
incentives noon kasi volunteer lang itong BHW. Ang incentive lang namin noon eh yung
pamsahe lang pero totally na wala. Hindi naman yung incentive ang kailangan namin or
yung mga kwan. Ang benefits lang namin dito is yung makatulong kami sa mga parents
lalong-lalo na sa mga bata. Minsan dina direct to the poin ko yung mother “anlaki laki
nng katawan mo tapos yung anak mo malnourish” ang dapat na I feed mo diyan ganito
ganito.
“Meron na rin konti pero okay lang. kasi hindi naman namin kailangan yung talagang
malaki. Ako talagang ang purpose ko pa lang noon ay makatulong ako sa mga parents.
Kaya ang sinasabi nila nung may ano na kami sa cauayan kay maam Beth Africano bakit
ko ginusto ang volunteer na BHW e teacher pala ako. Ayaw ng asawa ko maging teacher
ako kasi, baka ako daw ang bubuhay sa kanya yun ang reason ng mga kapatid ko. Ang
purpose ko naman gusto ko makatulong sa mga tao.”(Participant A)
Yes of course. I have been working as a health worker for 30 years but then I decided to
leave. My father-in-law used to be the Barangay Captain for how many years, there are
no incentives during that time for volunteers of BHW. The only that we have is the
transportation allowance. I don’t really need the incentives or anything. The only benefit
that we gain is to help the parents especially the children. We pointed out that some
mothers have big bodies but their children are malnourished. The children should be fed
with nutritious food
There is a little bit incentives, but it is okay because we really are not after the incentives.
My real purpose is to help parents. That is why people kept saying me that, why I still
want to volunteer as a BHW if I am a teacher. My husband and siblings do not like me to
become a teacher because they thought that I would become the bread winner of the
family. My purpose is to help the people.

This statement of Partcipant A resembles to the article of Lasco(2018) he stated
that barangay health workers only get a monthly allowance of Php1,150 from the local
government, being officially classified as volunteer.
It also resembles to the study of Itturralde(2010). As eloquently stated by
Itturalde(2010), BHW serve as community volunteers serving community health centers
without fixed salary compensation. They often serve as added workforce serving as
extension work by doing manual such as helping in maintaining the cleanliness of the
center, guiding and controlling patients’ record and patients flow in the clinic.
“Para makatulong din naman sa aming purok dun sa nagbibigay ng vitamin
ganun…kung may problema dito sa bara barangay sinasabi naman namin…kung wala
kaming trabaho tuwing lunes kami nagduduty, kahit hindi namin duty pumupunta pa rin
kami…schedule ng mga bakuna.”(Participant B)
In order to help our barangay specifically my assigned purok where in we distribute
vitamins. If something bad might happen we usually say it to barangay officials. If we are
free on Monday even we are not dutied to be at work we used to came because of the
schedule of vaccination.
“Incentives opo hindi naman kaya after incentive eh, masaya kami kasi…kasi kapag
matagal ka na sa serbisyo at mahal mo yung trabaho mo hindi importante yung

incentives basta ano lang kapa nakakapaglingkod ka ayy…ano ka sa serbisyo…sa
barangay ganun.” (Participant C)
It is okay even our incentives are insufficient. We are happy…because if you’ve work for
a long time and you love your work it is not important to have a greater value of
incentives as long as you serve in your barangay.
This statement resembles the Republic Act 7883( Barangay Health Workers and
Benefits and Incentives Act of 1995) sought to provide incentives to them in recognition
of their services. Is is specified that BHWs are entitled to hazard and subsidence
allowance trainings, civil service eligibility, free legal services, and access to loan
services. But according to Panay News(2017), it did not provide fixed rate allowances
and local government units vary in the rates and benefits they provide. Consequently,
many BHWs become underpaid and receive far less than what their other counterparts
get.
“Para tumulong sa aking barangay kahit mahirap kakayanin ko.” (Participant F)
In order to make help for my barangay even it is hard I will make a way to survive.
“Gusto kong makatulong naman kahit papano magamit ko naman yung experience ko
kung yung mga kaalaman kong konti para makatulong naman dito sa barangay”
(Participant G)
I really want to help in our barangay even merely on my experience and little knowledge
I had.
Different case with Participant D and Participant H but have the same reason with
the 5 participants. The Participant D said that it is their assigned kagawad who brought
her to the position while the Participant H is her sister choice.
“Inalok kasi ako ng kagawad nun dito na ako na lang ang ipapasok bilang BHW eh
pumayag naman ako kasi gusto ko namang makatulong sa mga bata ganun na pag may
bakuna ako yung taga…assist.” (Participant D)
I was chose by the kagawad here for Barangay Health Worker position and then I agreed
because I want to help especially the children in completing their vaccination and to
assist.
“Choice ng siter ko, kaya ako naging midwife ngayon, pero ginusto ko na rin, masaya sa
pakiramdam ang maktulong sa kapwa as public servant”(Participant H)
It was a decision made by my sister why I became a midwife. After a year, I became to
love and like it. I am happy to serve as a public servant.
On the other hand, Participant E has different case where in it is not her passion
totally to become a health worker because her mother-in-law need to take care her sister-
in-law who given birth.

“Ano, kasi hindi ko naman totally gusto yung biyanan ko ang dating BHW yun yung
unang-unang BHW…nung nanganak na yung hipag ko siya na yung nag-alaga ng anak
niya kaya ako yung pinalit.”
I totally didn’t want to be a barangay health worker. My mother-in-law was a former
health worker but then she decided to take care her child(my sister-in-law) who suddenly
give birth. And she decided to take me and fill up her position.
Work Experiences of Health Care Providers
The second purpose was all about their work experiences. Six out of seven health
care providers (BHW) stated that they are not allowed to make an injection.
“Yes of course kasi kailangan lalo na pag marami ang bata at pagka talaga kung kwan
kailangan talaga naming mag inject dahil hanggang dito lang naman(braso) kaya
kailangan sa mga bata yung full na hawakan mo at saka hindi pwedeng maging strong
siya dahil talagang hindi basta-basta mag inject kailangan yung parang relax na relax
lang yung bata saka mo lang injectan”
Of course, we need to inject especially when there are a massive group of children. It’s
important for the child to handle it tightly and they should not let them be strong because
it is not easy to inject, it is necessary to relax the child before injecting it.
“Wala, saka hindi kami pwede mag-inject, midwife lang ang nag-iinject. Nag-aassisst
lang kami sa mga bata.”

We are not allowed to inject only the midwife can. We are only assisting children.
“Hindi po kasi bawal po kasi sa amin kasi wala laming seminar. Hindi po advisable na
mag-inject pwede mag-assist lang po kami.”
No, we’re not allowed because we don’t underwent a seminar. It is not advisable to
inject, we only assists.
“Hindi, hindi pa na try kasi wala namang training mag-inject…yun kwan lang mag bp”
No, we didn’t try yet because we don’t have a proper training. We only do a checking of
blood pressures.
Particpant D statement reflects to the study of Ampong(2006), in her study
revealed that enhancing the knowledge and skills of the BHWs improve the hypertension
case finding and compliance of community residents to visit the healthcare centers to
blood pressure monitoring service. But through education and training should be done by
BHWs to ensure knowledge retention and accurate blood pressure taking practice.
This stamenent also resembles to the study of Juhan, as studied by Juhan(2014),
BHWs are effective in increasing the knowledge and improving the blood pressure
monitoring compliance among hypertensive individual in Barangay of Diplahan
Municipality, Zamboanga Sibugay Province.

“Ay hindi pa hindi pa kami pwedeng mag-inject kasi hindi kami naka undergo ng
training ng mag-inject ng tao…pwede kung nak undergo ka ng training pero kung hindi,
hindi po pwede, bawal.”
We are not allowed to inject because we didn’t undergo training to inject people. It is
possible if you underwent training but if not it is prohibited
“Hindi po kami allowing kasi BHW po, nursing lang tsaka midwife ang pwede”.
We are not allowed. Nurses and midwife only can do.
“Ay hindi pa bawal kasi sa amin na hindi naman kami na training hindi naman kami
pinag-aralan yun hindi naman kami pwede mag-inject.”
Not yet it is restricted because we don’t undergo further trainings and studies.
On the other hand, Particpant A shared her trainings and seminars about breast
feeding.
Nagte-training kami about nestle kasi kailangan naming isuggest sa mga bata at sa mga
nanay na dapat kung mix ang feeding nila, breastfeeding and then bottle feeding ay
kailangan naming isuggest sa kanila about nestle product. Yun ang purpose ng seminar
namin.
Of course anak nagtraining kami, seminars hindi naman totally na training. First timer
kasi ako rito year 1980. I’m already 67 yearsd old gusto ko ng mag quit pero ayaw nila
akong payagan kasi maganda ang performace ko and then magaling akong mag
approach ng mga bata na mag pa inject even mga parents na ayaw mag breastfeeding.
Ang pinaka dabest kasi kailangan ang yung hindi dapat na mix mix. Okay lang pag ang
mother ay may trabaho pero pag nandito ka lang sa bahay ang talagang sinaSuggest
namin sa mga parents full na breastfeeding hindi na kailangan ang mix pero syempre
yung mga kwan gaya nung nestle and then yung gaya nitong may nag seminar na naman
sa amin about sa kailangan kasi ang zinc sa mga bata na tamad kumain lalo na pag
gulay eh kailangan ang bear brand na gatas kailangan na namang isuggest namin sa
mga bata na mag take ng bear brand once a day.
We are having our trainings about nestle because we need to suggest to those children
and mothers that if their feeding is mixed, bottle feeding and breast feeding. We need to
suggest those nestle products. That is the purpose of our seminar. Of course we are
trained, seminars can be but not tottaly training. I am first timer way back 1980. I am 67
years old I wanted to quit but they do not want to allow me because my performance is
very promising and I know how to approach the children very well to get injected. Even
the parents does not want to breast feed. The most needed is not the mixed. It is okay if
the mother is working but if the mother is just staying in their house we really suggested
that they do not have the mixed but of course the nestle products. And then just like our
recent seminar it is all about the needed zinc for the children that are lazy to eat
especially vegetables. That is why we suggested that they need to take bear brand milk
once a day.
This statement resembles to the study of Aipichi, according to Ateneo De
Zamboanga University (Aipichi,2007), barangay health workers are essentially the
frontline health service providers of the community health centers. They serve as the
assistant ego of the barangay health nurse if present. These BHWs therefore has to
equipped with knowledge and health teaching skills. In this study, the researchers found
out that film viewing and with the combination of health teaching training session are
effective in improving the knowledge and health-teaching or competency of the BHW.
Contrarily, Participant D in her statement that she had learn in her work and get
enhanced in her working skills.
“Yung experience ko as a health care provider(bhw) doon na enhance yung knowledge
ko kung paano maki cope up ng sa mga bata, yung nakilala, naalam mo na mapag-
aralan mo ang ugali ng mga bata. Yung kasi sakop naming is 0-59 months, ngayon
noong hindi pa ako health…BHW parang wala akong paki sa surroundings ko ano, pero
noong nag BHW na ako doon ko nalaman ang kahalagahan ng pagiging health worker
yung pagiging pag-aalaga sa kalusugan una sa mga bata.”
My experience as a health care provider(BHW) where I enhanced my knowledge on how
to interact with the children and how to orient towards to the behavior of children. We are
subject to assist 0-59 months old children. When I am not yet in the position I act as if I
don’t care but when i became as a BHW I made to realize the importance of having a
good health for children.
Different case with Participant D stated that sometimes they are not trusted by
their fellow residents, the struggles in house-to-house visitation and vaccination problem.
“Ay marami ah…kasi may nae-experience kami pa kami na pag nagtitimbang kami
ganun nay nagsasabing panay naman ang timbang namin ganun…wala naman kaming
nabibigay daw pero meron kahit papano naman kaming nabibigay na kwan Vitamin A
dalawang beses sa isang taon.
Pag nagha house to house kami…nung nag house to house kami met keta jay lang
panggep met ti ubbing ti kwakwaen mi agited ti purga kasjay, nu adda ti naganak mapan
mi lang kitaen ikkan mi ti vitamin A ajay mother…Last October ata yun nung naghouse
to house kaming magbakuna may mga ayaw ipabakuna mga anak nila kasi sabi nila baka
daw dengvaxia yun… pero sinasabi naman ng midwife naming na hindi kasi kwan lang
naman kasi anti measles lang naman yun.”
When it comes to experience, I experienced a lot. I’ve experience people who used to say
words that we weight children over and over again…they also say that we don’t give
anything like medicine but we do had Vitamin A twice a year. During our house-to-house
work we give purge laxative for children. Last October during our house-to-house there
are those who do not want their children to be vaccinated because of dengvaxia rumored
issues. However, the midwife always trying to convince them that it is for anti measles.
Similar statement with Participant E who experienced also house-to-house
problem and delayed vaccines.
“Sa experience marami…kasi…bukod sa hirap na magtawag pagdating sa pagbabakuna
dahil takot silang magpabakuna ng anak dahil simula nung lumabas yung dengvaxia
diba?. Tapos nung una malayo masyado kasi sitio na yung iba masyadong malayo
parang purok dito hanggang health center hindi talaga sila makapunta pag walang
sasakyan. Sa seminars, training naman dati kasi pero nitong lately wala masyado pero
okay naman lahat ng trainings naming saka seminars naming.”
“Marami din, unang una pag pumunta ka sa isang bahay, diba magha house-to-house
kami magbabakuna kami with midwife, tapos minsan magpapatak, magtitimbang kasi
yun yung lagi naming inaano. Challenges naming madalas is yung pumunta ka tapos di
ka haharapin, pumunta ka tapos pag maraming aso hahabulin ka pa, pag pumunta ka
sapilitan mo pang kailangan mo pang ipaliwanag na kailangan nilang magpa-inject,
ultimo Vitamin eh mahirap pa mabigay”
There is a lot of experiences…besides it is hard to call them since they are afraid of their
children to get vaccinated since the dengvaxia came out. Some could not be able to attend
because of the distance from their house to the health centers and vice versa. In seminars,
we have a training before but lately there is not that much training but our trainings and
seminars are actually good.
During our house-to-house visitation, we are assisting miwife during our vaccination and
monitoring childrens’ weight. Our frequent challenges duriong home visits are not get
involve with the patients, chased by dogs, and you need further expalnations why it is
necessary to have their child vaccinated and also vitamins.
The first statement of Participant E resembles the findings of Tomacruz, other
public health programs and health workers were also greatly affected in the post-
Dengvaxia scandal . after the dengvaxia scare, parents were afraid of any kind of
intervention, not only for vaccination( Tomacruz,2018).
Participants F supported this statement
“Uhmmm…my challenge is as matigas ang ulo ayaw nalang pumunta sa mga
papagsasabihan mo mag-inject sa mga measles natatakot sila pero iniexplain naming
kung anong ibig sabihin ng measles pumupunta din naman sila kahit matigas ang ulo.”
One of my challenges are the people who do not want their child to be vaccinated about
anti measles but when we clearly clarify the agreement now is okay.
Participant G has also same cases with Participant D because in her earliest time
at work she is not been trusted by the people.
“Nung una na ano BNS pa lang ako eh yung mga tao parang ayaw nmaniwala na
magampanan mo yung trabaho mong ganun eh nagtata nagtatawag ka sa kanila prang di
sila naniniwala para ma…don sa ano batay sa mga exs..makikita mong reaksyon nila
dun mo huhugutin yung lakas ng loob mo para mahatak mo sila kasi pag pag hindi mo i-
pwer..ipursigi hindi mo rin magagawa, mag pursigi ka lang maaa ahh parang ano sila
ng ano maipapangaral mo sa kanila para… malaman nila na kay mo rin gampanan yung
trabaho mo na ano pinasok mo.”
When I am still BNS the people does not want to believe that I can handle my work. You
are calling them but they do not believe in you. You can see their reaction and that is
when you will pull up your confidence to prove them that you can really do your job well
done.
Particpants H has different case among the seven participants but the dedication to
work and to the people are alike.
“My challenges, nung nag enroll ako sa midwifery school sabi ko dapat makagraduate
ako, after grad, makapasa dapat ng board at makahanap ng trabaho. Everyday iba iba
challenge, example kung may 4 na patient kang dumating iba iba sila ng case or health
problem, kailangan mo talaga I assess one by one para sa cure ng sakit nila. After
passing the board of midwifery naghanap na ako ng trabaho, nag-volunteer sa mga clinic
kay Dra. Aquino, Dra.Caballero at nagging clinician din ako ng medi rx company. 1998
natanggap ako sa district 1 bilang barangay midwife hanggang October 2017, October
2017 to present sa Pinoma ako…nagtagal ako sa profession na to kahit maliit ang sahod
kasi minahal ko at enjoy ko ang trabaho ko. Nagpapa anak kami noon sa bahay, breech
delivery, circumvission na experience ko, kahit anong oras ka tawagin 24/7 on call kami
noon basta may tumawag pupuntahan namin…I attended convension, seminars like
IMAP(Integrated Midwives association of the Philippines) at plgmi.“

My challenges are, when I enrolled midwifery in school I told my self to graduate first,
after the graduation make sure that I will pass my board exam and find a job. There are
different challenges every day, example is that if there are 4 patients and they have
different health problems, I need to assess them one by one so that I can cure the health
problems. After passing the board I immediately find a job. I volunteered to the clinics of
Dra. Aquino and Dra. Cabellero and I laso become a clinician of medi rx company. It is
1998 when I got hired as barangay midwife in district 1 until October 2017, octeber 2017
to present I went to Pinoma…soon after this profession of mine even if the income is
little I still love and enjoyed this job. We are assisting the mothers to give birth to their
house, breech delivery, and circumcision. Everytime someone call us asking for help we
will go and assist them 24/7. I attended conventions, seminaras like IMAP( Integral
Midwives Associations of the Philippines) and plmi.
This statement resembles the finding of Belcina and Selsina, due to a lack of
barangay health station and facility in Bag-ong Dalaguete, one midwife who is a Local
Government Unit employee is assigned to monitor the health and the nutrition status of
the residents particularly the children. The assigned midwife caters four other barangays
and is scheduled to visit every Tuesday of the month. Aside from midwife the barangay
has also one BHW who monitors and tracks pregnant woman in the barangay (Belcina
and Selisina, 2018).

Common Health Problem in a Community
The third purpose talk about on the health problems in barangay. Participants
stated mostly about cough, cold and fever are frequently diseases.
“Kadalasan eh kwa lang met ubo kung minsan lagnat, sipon”
Frequent diseases such as cough, fever and cold.
Participant F support the statement.
“Ay mostly dito mga ubo’t sipon, mga measles, saka sa mga boils maraming boils
ngayon eh sa panahon na ito. Alam niyo ba nga boils? Littig, hindi yung boil na
kumukulo. Nagtatae tapos lagnat nga.”
Mostly boils nowadays are the common health problem. Diarrhea and fever.
Participant C also support the statement.
“Yung iba naman na may sakit na kwan TB ganun ayaw nilang magpakwan di nila
kinukumpleto yung mga gamutan nila…Ubo, sipon ganun…humihingi sila ng gamot
minsan wala namang gamot na galing sa bayan.”
Others who had Tuberculosis(TB) they usually not made to finish their medication.
People who had cough and cold are making a request for a free medicine yet there is no
stock from city health office.
This statement resembles to the study of Credo(2009), in her study concluded that
the establishment of modified DOTS sites with performance-based incentive program

among the BHWs can motivate BHWs on strict enforcement of DOTS strategy thus
contributing to the improved treatment adherence and compliance by the TB patients.
Participant D statement is about the problems in vacinnating babies and also
stated about the frequently diseases.
“Yung common health problem namin dito sa Pinoma yung hindi kami ano lalo na sa
vaccine doon kami nahihirapan yung iba kasi hindi nagpapabakuna kaya dapat I follow
up mo siya kung talagang schedule na ng vaccine niya tapos yung mga, kasi yung cover
namin pregnant tsaka yung mga bata na 0-59 months tapos kadalasan sakit ng mga bata
ubo, sipon, tyaka lagnat yun yung common na sakit ng mga bata minsan may nagtatae
din ganun pero kulang lang sa supply ng gamot yun yung common na problema.”
Our common health problem here in Pinoma, we are having difficulties in vaccination
some did not attend so you need to follow up them especially the pregnant woman and
mothers with 0-59 months old children. And then the frequent diseases such as cough,
cold and fever.
Particpant A also support the statement of problem in vaccination and highlighted
the scarcity of nutritious food for children.
“Yun nga lang yun diba gusto mo man bilhin yung mga gustong pagkain ng mga bata
they can’t afford. Yung iba naman inuuna yung ibang pangangailangan kaysa sa mga
bata kaya maraming bata dito na pagala gala ohh diba nakikita mo naman na marami
paring mga bata na di nakakapasok sa school at inuuna dun sa pagtatanim naiiwan yung
mga bata na kwan kaya doon. Alam mo ang sinasabi namin sa mga parents na hindi pa
nagpapabakuna na kung minsan dahil house to house dalawang beses kaming nag house
to house december tsaka ngayong march lalo na yung Japanese na naman na i-inject
namin this coming ahh maybe ahh mga last week of march or aabutin ng april.
Kailangan kasi mga parents meron din kasi yung kwan kaya nga wala kayong
makukuhang barangay clearance sabi namin para pang ano lang kung ayaw ninyong
ipabakuna yung mga bata hindi para sa inyo yun para sa mga anak niyo yun ang suggest
ko. Walang bayad. Meron isang tatay na ayaw talaga kaya nga gumawa kami ng ahh
waiver para lang pirmahan niya yun at pero ngayon yung first na nagbakuna at
naghouse to house kami pero ayaw talaga pinagawa gumawa kami ng waiver
pinirmahan then ngayon eto nung isang araw lang kami nag ano nag house to house nag
pabakuna rin sa wakas. Diba natakot sila dun sa Dengvaxia ohh diba pero yung
dengvaxia na yun dun lang sa maynila hindi nakarating dito sa probinsya. Kaya sabi
namin kilala niyo naman kami once na may nangyari sa bata di kami ang sisisihin niyo
ganun kami mag explain. Kaya marami na rin totally 100% na kahapon ang
nabakunahan dito sa Pinoma.”
Even though how much parents really wanted to buy food for the children but they can’t
afford, the other parents prioritize more their self needs rather than to their children so
that many of them can found at street. As we can see there’s a lot of children who doesn’t
be able to go to school because of child laboring. We are saying to those parents who did
not vaccinated their children, thus sometimes we perform house-to-house visits atleast
twice a month. There is a father who does not want to get his child vaccinated so we
made a waiver just for him to sign in, it does mean that the barangay is not responsible
if something might happen to the child. Last time we had a hopuse-to-house and for the
first time they agreed. But then, they were afraid because of dengvaxia but it is onl;y in
Manila it does not reach to province areas. Thus, we usally says that once something
happen in the child we are the one you could blame for. Yesterday its completely 100%
got their children vaccinated.
Participant E statement is about malnutrition for children.
“Malnourish na rin sila ditto…kung sa sakit naman ditto sa bata, ah…
malnourish,oo,meron sa sakit…kung ano kasi yung uso yun yung meron…,kung
ubo,sipon ganyan kung…wala pa namang break out ng tigdas ditto, meron na
siyang…meron ng nagkaroon pero naagapan naman siya”
Most children here are having a malnutrition. If cough and cold is the trend the diseases
then that woul be. There is none yet break out of measles here, one had but it was easily
cured.
Participant G support the statement.
“Kadalasan yung ano uhh halimbawa sa mga magulang na may anak na severely
underweight hindi sila ano hindi sila gaanong ajay hindi gaanong marunong na
magbigay ng mga sapat na pagkain ng mga bata yung dun sa sana sa ano masustansya
na pagkain mas gusto nilang ipakain sa ka kanilang mga anak yung junkfood na
madalian lang hindi kagaya sa ano mga iba na pipiliin nilang ipakain sa mga anak nila
na yung mga masusustansyang kasi sila karamihan pa kung sino pa yung mga may anak
na ganun eh sila pa yung tamad magpakain.”
Sometimes those parents having children that are underweight doesn’t know the proper
food for their children. Parents should be able to prepare or cooked nutritious or healthy
foods most especially those parents whose children is underweight.
On the other hand, Participant H stated about the high blood pressure and people’s
unhealthy lifestyle.
“Madaming hypertensive patient sa Pinoma siguro dsa lifestyle nila diet nila”
The ratings of hypertensive people in Pinoma is getting higher because of their unhealthy
lifestyle.
This statement resembles to the study of Taburnal(2017), in her study revealed
that healthy living in the community is affected by many factors with the presence of
BHW who inspires and motivate community people to live in a healthy lifestyle, which
are competent, committed a having the relevant as BHW can provide quality healthcare
services to their constituents. The personal, political, and environmental factors affect the
level of competence of BHWs. The continuous attendance to seminars and trainings are
highly recommended to enhance their performance.

Strategies in Dealing with Challenges
The fourth purpose was all about the strategies or techniques in coping challenges
at work. Two out of eight health care providers answered that your good relationship to
people would help to convince individuals to trust you.
“Adda met ajay maallukuy mi met garud nukwa ket nu maybaga mi jay rasonen nu apay
anya ti gapu nga agit-ited ti midwife ti kasjay adda met jay pumayag nukwa adda met ti
saan…ajay ngay kasla kwaen mi isuda maam…ibaga mi nga agpabakuna …na dapat nga
mabakunaan jay ubing idi pay lang kayyanak na dapat napabakunaan kuman…ti BCG
tapos after 6 weeks agbakuna kuma isuna iti penta kasjay…pero adda met inang nga
mapmapan pero adda latta met iangan nga han mi nga mapilit nga mapan pero nu
danunen mi metten kayat nantu mettten nga ipabakunan maam…ta ittuy lang purok kon
ket talaga adda ti kasjay ket madi nga mismo nga mapan jay health center pero nu
mapan ni midwife kayat da met lang.”
There are times that we convince them when we clearly explained to them the reason
why we are having a vaccination program. We used to say that a newly born baby need to
be vaccinated with BCG then after six weeks Penta must be vaccinated. There are
mothers who volunteer to came and some are really not but when we get through their
house, they agreed for the vaccination and this usually happened in my designated purok.
Participant A supported this statement.

“Ehhh syempre yung dika ma PR kung masungit ka ay masungit yung pupuntahan mo
tapos masungit kang nakikipagapproach talagang walang mangyayare dapat talagang
iconvince mo sa magandang usapan ganun hindi dapat na ayaw na nga lang tapos
magagalit kapa kahit saan kapa ... pag wala kang PR yun din ang mahirap kaya nga sabi
nila ako daw malaking ano dahil malakas ang convincing power ko. Kukunware lang
sinasabi namin na walang record tatawanan lang naman kami nun pero ang pinakadabes
kase sabi namin para sa kalusugan ng mga anak niyo. PR yung Public Relation. Yun ang
talagang kailangan naten sa kapwa natin kung...gaya nung sa tindahan namili ako nohh
pag masungit ka hindi nako bibili ganun lang yun. Kailangan ang talagang pakikisama.”
If you don’t have the public relationship and if you’re rude and you don’t know how to
approach nothing would happen. You should convince them in a good way of
conversation. And if she didn’t really want it, do not be mad at her. Wherever you go if
you don’t have the public relationship that’s also hard. They say I have the convincing
power. Let’s just say we don’t have a record but they just laugh at us but the best that we
can say is that for your child’s health. Just like if I am in canteen if you’re rude I am no
longer buy to your canteen that’s why we really needs fellowhip.
These statements resembles to the study of Beranrdo, in her research focused on
the communication strategies used by barangay health workers in promoting reproductive
healthy among Iraya-Mangyan communities. It was revealed that the Iraya-Mangyan
comnmunities strong prefered inmdividual channels(i.e.,home visits and counseling) in

communicating rewproductive health information. When it comes to the approach used in
communicating RH information , the respo9ndents’ preferred the entertaining approach.
Participant C has the same statement with Participant A and D but she stated
mainly about humility.
“Ayy yung mga strategy ko? Minsan strategy ko yung kasi sa amin ano mga bata
sasakupin mo pa yun mga designated purok mo ano, yung mga yung mga common
problems ko minsan yung lalo sa may mga relief aawayin ka ng kapurukan mo kung bakit
hindi sila nabigyan , misan ang strategy ko mag pakumbaba, misan meron pang na-
encounter na akong ganun masam yung loob ng tao sakin minsan kung hindi ko siya
ay…gagawin ko siya kung paano ko I approach ulit minsan eh diba pag ano kami pag
may nasabi siyang hindi maganda tapos sasagutin ko ng medyo may ganun-ganun na edi
hihingi na ako sorry, pinagpe-pray ko na lang siya na at the following day mag-kabati
kami kung ano pwede kong gawin na basta gawin lang yung trabahong maayos kung sino
talagang dapat mabigyan ng tulong sa purok mo yun lang ang bibigyan.”
I am in-charge to children. My common problem is about relief goods. Your own
designated purok will rebuke you because they were not given a relief goods. Sometimes
my strategy is to humble at all. One time, I encountered a person that has uncomfortable
feeling on me and I will be the one to approach first. Then if she says rumors about me I
will talk to her and say sorry at the end. I will pray for her and at the following day I
make sure that we’re already in good terms. I’ll do my work with the best of my best to
help my purok.
Aside from the statement of Participant C, A and D, Participant E gave her
statement also about convincing people but if not made, a waiver from barangay officials
will be given to the parents who would not be able to made the vaccination for their
children.
“Isa’t isa lang naman strategy namin eh para…ano kausapin at puntahan lagi, palaging
ganun puntahan lagi namin, sila I house-to-house sila, pilitin lalo yung measles…diba
nagka measles out break? Yung measles out break kailangan lahat mabakunahan, 6
months to 5 years old…59 months magfa-five pala marami pa ring hindi pumupunta kaya
ginagawa naming in house-to house na lang talaga, binabahay-bahay naming sila para
matapos, kasi pag hindi mo sila, kasi pag hindi mo sila pupuntahan hindi rin sila
pupunta, yun yung nagyayari kasi dito pero yung iba talagang ayaw hindi na naming
inaano talagang waiver na ang ihaharap naming ganun. Yun na lang kasi strategy namin
yun lang.”
One of our common strategy is to talk and visit them. Insist them to get their child
vaccinated with anti measles because of the measles out break today. During the
vaccination day those who didn’t bring their child we would be able to visit them and for
those who refused, the waiver from the health center would be signed through them that
no matter what happens the barangay is not responsible for it.

On the other hand, Participant F and Participant G made their convincing power
through the presence of medical missions in barangay.
“Eh…ginagawan naming ng paraan kungggg marami namangg nag ahh…memedical
mission dun naming sila hinihkayat na pumunta naman sila para kompleto ang kanilang
binibigay na gamot para inumin ng mga bata na may sakit, matatanda” (Participant F)
We are making techniques and strategies to convince them to have an avail of free
medicines for children and adults like if a medical team conducting a medical mission.
“Ang mga ginagawa namin ah nag cocondu… ay humihingi ako dun sa bayan ng ano
uhh pinupursige ko sa mga Barangay Official na makiusap sila kay Mayor para maka
avail kami ng mga gamot. Halimbawa may mga gamot makakahingi kami dun tatawagin
namin yung mga tao lalo na sa pag may medical mission ipinupursige namin na pupunta
sila para kahit papano kahit karamihan eh puro nalang ano umaasa naman na hihingi
nalang dun sa bayan puro sa bayan. Kung may medical mission naman hindi rin sila
pumupunta kaya pinupursige kami na pumunta sila yun ang ginagawa namin.”
(Participant G)
What we are doing is we are asking for a request to barangay officials to beg for City
Mayor in order to make a reservation of medicines. For example if we got an avail we
will call for people for free medicines especially if ther is particular medical mission,
with that we are trying to convince them.

Different case with Participant H, patience and love is indeed for long duration of
work
“Need ko talaga dito mahabang pasensya, love and enjoy yung work para makatagal sa
trabaho, pakikisama, tapat sa sarili may takot sa Diyos at may word of honor.”
I really need a long patience in my work. You should love and enjoy your work in order
to get lasts on the job. Dealing with people is needed and fear to God and had word of
honor.
CHAPTER V
SUMMARY OF FINDINGS, CONCLUSIONS, AND RECOMMENDATION
This chapter was composed of three main parts. The first part gave the most
important information. The final discussion of the study was presented. The last part was
the recommendation for research. Moreover, this chapter is the compilation of conclusion
and recommendation.
Summary of Findings
The researchers presented and analyzed all the data gathered and found the four
purposes.
The first purpose was all about the life experiences of health care providers. There
are five out eight health care providers in their statement that they really want to help
community residents and serve as a public servant. The salaries simply the incentives are
not important if you have used to love your work. The rest three participants stated that it
is not their choice, but then the two realize and learn to loved their work.
The second purpose of the study was all about the work experiences of health care
providers. There are six out of seven health care providers (midwife not included) said
that injecting is not allowed to them because they did not undergo trainings. They usually
have a trainings regarding on feeding babies. They became more skilled health worker.
However, they seem to be disrespected because people are not usually trust them. They
also struggle in house-to-house visitation because of delayed vaccination and could not
convince people.
The third purpose in the study was all about the common health problems in a
particular community. Cough, cold, fever and diarrhea are usually the frequent health
problems. Malnutrition and lack of food are added as the common health problems.
Hypertensions are usually with adults.
The fourth purpose of the study was all about the techniques and strategies in
dealing with challenges. Two out of eight health care providers said that the public
relationship is a must to be a health worker. Your convincing power are really helpful
during house-to-house day. The humility and your love to your work is indeed a required.
Conclusion
The researchers defined barangay health workers and midwife as health care
providers. All health care providers not only in Pinoma, Cauayan City, Isabela but in
every corner and even mountainous barangay or sitio in the Philippines have been
through many challenges in life and work. Health problems and home visitation in a
particular community have been to become the common mentioned challenges. That is
why they used to have public relationship and humility to the patient residents and
convicing power as well.

The more trainings and health related seminars for health care providers
especially the barangay health workers would be very beneficial. These could be used to
level up and enhance more the skills and startegies of barangay health workers. Every
health center is equipped to provide primary level of health care. Its goal would be
beneficial to all. Barangay health workers serve as the chage agents in their
communities. They often assist midwife in immunization and vaccination program and
usually provide assistance in house-to-house visitation.
Nevertheless, nowadays, health care providers continue to work as one
and work together for every child get vaccinated and immunized.
Life Experiences of Health Care Providers
Being a barangay health worker and assigned midwife with a cheap salary and
insufficient allowance is really challenging. You used to become a public servant and a
volunteer as well. If helping and volunteering are really your passion as if no matter how
higher the value of the salary you have, the point system is that you are happy at your
work and looking forward for the positive outcome for the hardships and sweats spent.
Work experiences of Health Care Providers
Before becoming a barangay health worker, it is required to undergo trainings and
attend necessary health related seminars. BHW and assigned midwife when combined is
health care workforce. During house-to-house day midwife serve as the convincer in
order to get parents agreed with the injection. Professionals like midwife are only allowed
to make the vaccination but for the barangay health workers that are not underwent
trainings related to the said process are strictly prohibited.
Common Health Problem in a Community
Cough, cold, fever, diarrhea, measles and malnutrition are usually frequent
diseases. However, these diseases are the leading cause of child mortality and morbidity.
Hypertension are also the leading cause of death of most Filipinos due to un
health lifestyle and bad body habits. Tuberculosis patients must be finished its medication
with the help of health care providers through TB DOTS.
But through the help of health care providers in a particular community towards
to a certain health problems, these deaths could be prevented by the presence of health
care providers that are trusted to implement in resource-poor setting.
Strategies/Ways in Dealing with Difficulties
Different strategies, techniques and ways are usually implied in overcoming those
challenges. As a health care provider in a community which deals to different kind of
patient, the public relationship is highly recommended. Convincing power should always
wear on a house-to-house day. Humility must be still remains at all times.

Recommendations
1. The community of Barangay Pinoma is actived enough in terms of Health Care
Providers but the researchers would recommend that only the midwife and well-
trained Barangay Health Workers will have the authorization to inject.
2. For the Barangay Health Workers, the researchers noticed that the salary given to the
BHW a month is not enough. They should have sufficient salary excluding the
incentives given by the government.
3. For the Barangay Officials, they should conduct a barangay health awareness
seminar for them to have information about health of everyone.
4. For City/Municipal Mayor, they should have support health care providers
financially.
5. For the future researchers, if you were conduct a similar study, include the schedule
of check ups to know more information regarding the time schedule and know more
information on how do they handle the patients.
6. For the Barangay
 Put a public number for them to contact the health care providers
 They should have cooperation with the district hospital
 They should have a knowledge and skills as a BHW in their barangay.

Experiences of Healthcare Providers

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Experiences of Healthcare Providers

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University of Perpetual Help System Laguna

Minante Uno, Cauayan City, Isabela

Biñan Calamba GMA Isabela Las Piñas Manila Molino Pangasinan

Barangay Health Workers(BHW), also known as Barangay Health Volunteers, are

BHW is qualified to provide primary health care services in the community it is

responsibilities of a barangay health worker: first aid, equipment sterilization, assisting in

participating in community meetings, assisting in nutrition education, monitoring and

feeding, assisting in immunization education, monitoring, and dispensing, assisting in

Biñan Calamba GMA Isabela Las Piñas Manila Molino Pangasinan

Health services should be accessible to all citizens. The population growth

access to health services (Taleshi, 2009).

needs of of expectant of mothers-to-be as they go through their pregnancies, responds to

services rendered to the community.

encountered by Health Care Providers.

Biñan Calamba GMA Isabela Las Piñas Manila Molino Pangasinan

made used the Tannahill Model of Health Promotion (1980).

of three overlapping subjects of activity: health education, prevention and health

Health education is designed to change the knowledge, beliefs, attitudes, and

access to housing, employment, education, and health care.

medical model in that it pays insufficient attention to community-based factors. In

response to these critiques, Tannahill(2009) proposed a new definition of health

promotion as the sustainable fostering of positive health and prevention of ill-health

Biñan Calamba GMA Isabela Las Piñas Manila Molino Pangasinan

Education in his definition includes health education and interventions designed

along with those that damage it

Statement of the Problem

to answer the following questions:

1. What are the experiences of health care providers?

2. What are the challenges experienced of health care providers?

Assumption of the Study

regarding on their experiences of being a heath care provider.

Biñan Calamba GMA Isabela Las Piñas Manila Molino Pangasinan

coping strategies in overcoming it.

Scope and Delimitation

the experiences of healthcare providers.

Significance of the Study

The results of the study will be great benefit to the following:

conducting new researchers or in testing the validity of other related findings.

innovative that will be beneficial.

Biñan Calamba GMA Isabela Las Piñas Manila Molino Pangasinan

in barangay is challenging work.

workers is not a cheap option.

workers and midwives.

terms conceptually and operationally:

Barangay Health Centers- used manual system in terms of implementing medical

services, health programs, health monitoring and profiling (www.inetutor.com).

Community Health Centers- is a not-for-profit, consumer-directed health care

dental and mental healthcare (www.mtpca.com).

Biñan Calamba GMA Isabela Las Piñas Manila Molino Pangasinan

Directly Observe Treatment Short-cause(DOTS)- is a strategy used to reduce the

the midwife assigned in a particular community or barangay.

Integrated Management of Childhood Illness(IMCI)- integral approach to child health

years of age( World Health Organization).

Intervention- is a combination of program elements or strategies designed to produce

behavior changes or improve health status among individuals or an entire population.

Interventions may include educational programs, new or stronger policies, improvements

in the environment or a health promotion campaign. It may be implemented in different

Biñan Calamba GMA Isabela Las Piñas Manila Molino Pangasinan

settings including communities, worksites schools, health care organizations, faith-based

organizations or in the home (health.mo.gov).

Morbidity- refers to having a disease or a symptom of disease, or to the amount of

disease within a population. Morbidity also refers to medical problems caused by a